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procedural specialists rather than consulting physicians

when it comes to rebates for consultations. This allocation

Specialisation of SEM physicians

is completely inappropriate and not consistent with the
AMC’s recognition of our style and scope of practice.
Our negotiations with DoHA over this matter will continue
for some time yet.
While we have been disappointed with the outcome of
consultation rebate allocation, there have been many positive
consequences to specialist recognition. Probably first and
foremost is the formal recognition of SEM as a specialty in its
own right. This represents a validation that the preventative
and holistic approach to patient care which is inherent in
SEM Physician practice has a role to play in improving the
health care of the nation by increasing physical activity.
The government has often expressed its desire to increase
physical activity levels as it grapples with the chronic and
burgeoning consequences of physical inactivity.
From 1 November 2010, patients being referred for an MRI scan
by an SEM Physician are entitled to a Medicare rebate. This is
a major breakthrough as patients of SEM Physicians prior to
specialist recognition were financially penalised for having a
valid MRI investigation performed. It recognises that the ACSP
advanced training program provides doctors with the necessary
skill and expertise to judiciously utilise MRI in medical practice.
It removes the anomaly that existed prior to 1 November where
an SEM Physician could not refer a patient for a rebatable MRI
for an acute knee injury, but a psychiatrist could. This is no slight
against my psychiatry colleagues as they themselves are happy
to acknowledge that this inconsistency was ludicrous.
Recently we have also had another major success in
relation to diagnostic musculoskeletal ultrasound conducted
by SEM Physicians. Medicare recognises two levels of
diagnostic imaging rebate in relation to musculoskeletal
ultrasound. Where a patient is not referred by another medical
practitioner, the patient is entitled to a certain, lower level of
rebate. If the patient is referred to a medical practitioner for
ultrasound by another medical practitioner, a higher (referred)
rebate is accessible by the patient. A clause in the Medicare
legislation allows specialists, working in their field of specialty,
to self-determine that an ultrasound is required, even if a
specific referral for that ultrasound was not provided by another
medical practitioner. This allows obstetricians to perform
foetal ultrasounds, cardiologists to perform echocardiograms
etc. DoHA has recently advised that SEM Physicians do
indeed have the right to self determine the requirement for
musculoskeletal ultrasound, with their patients accessing
the higher ‘referred’ level of rebate from Medicare.

VOLUME 28  ISSUE 4  SUMMER 2010/2011 11